Surgeries:
Mon, Tues and Thurs: 8 am–12.30 pm and 2–6 pm, Weds and Fri: 8 am–2 pm

Ovaries

Menstrual cycle disorders
(amenorrhoea/oligomenorrhoea)

The causes of menstrual cycle disorders are diverse. The reproductive system is generally ‘powered down’ if a possible pregnancy would endanger the woman’s health.

  • Stress-related
  • Hormone-related, e.g. thyroid gland or pituitary gland diseases
  • Diseases of the ovaries, e.g. cysts, tumours, endometriosis
  • Due to other systemic diseases, e.g. cancer
  • Due to drugs, e.g. immunosuppressive or chemotherapeutic drugs
  • After discontinuing oral contraception
  • Premature menopause, e.g. severe conflicts in life

The medical history is important: why is the menstrual cycle irregularity disturbing? Are children desired? Are there complications due to the menstrual cycle disorder, e.g. mood swings or osteoporosis?

Clinical consequences of ovarian insufficiency

  • Symptoms of oestrogen deficiency, e.g. hot flushes, mood swings, listlessness, vaginal dryness
  • Infertility
  • Osteoporosis

Diagnosis

Laboratory tests:

  • Routine laboratory tests
  • Hormone tests: thyroid gland, pituitary gland, ovaries, androgens
  • Hormone test: LHRH test

Imaging:

  • Ultrasound examinations of the thyroid gland/ovaries
  • MRI of the pituitary gland

Therapy

Depending on the patient’s complaint symptoms and goals in life:

  • Hormone replacement
  • Stimulation of ovarian function
  • Contraception

Menopause

  • Physiological cessation of the ovarian function between the ages of 50 and 55
  • Complaints as above (see clinical consequences of ovarian insufficiency)
  • Therapy with natural hormones: oestrogens/progesterone, transdermal oestrogen continuously in the morning and progesterone for going to sleep; this prevents bleeding from occurring
  • Reasons for hormone replacement therapies (HRT): clinical complaints; osteoporosis is not a reason for beginning HRT, although this protects against osteoporosis, of course
  • General recommendation: 3-month therapy trial and then consideration of the advantages and disadvantages or the benefits and side effects

Do oestrogens cause breast cancer? No, but they cause a mammary carcinoma to grow faster. This is why women with a family-related risk of breast cancer should not undergo HRT. Regular mammography (breast cancer screening) is necessary

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